Journal CME, August 2022: Frequency, severity, and implications of shoulder pain in people with major upper limb amputation who use prostheses: Results of a National Study-Frequency, severity and implications

Frequency, severity and implications - article.pdf

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The study explores the prevalence, severity, and implications of shoulder pain in individuals with unilateral major upper limb amputation who use prosthetic devices. It involved 107 U.S. veterans and civilians, 97% of whom were male with an average age of 57.1 years and an average duration of 23.4 years since amputation. The study utilized a cross-sectional design with national recruitment.<br /><br />Key findings include:<br />- 30% of participants reported shoulder pain, categorized as ipsilateral (15%), contralateral (25%), or bilateral (10%).<br />- Shoulder pain was more common in users of body-powered prostheses (38%) compared to externally powered prostheses (18%). <br />- Each additional year since the amputation increased the likelihood of contralateral shoulder pain by 1.05 times.<br />- Contralateral shoulder pain significantly impacted health-related quality of life and disability scores, with worse physical component summary (PCS) and QuickDASH scores.<br /><br />Main outcomes showed that shoulder pain, particularly on the contralateral side, is a frequent complication in this population, with risk increasing with time since amputation. Functional performance and health-related quality of life are negatively affected by shoulder pain. The study suggests the need for targeted prevention strategies to address the cumulative impact of prosthesis use on shoulder health, emphasizing care for the shoulder opposite the amputation. The findings highlight the importance of optimizing prosthesis design and rehabilitation to mitigate long-term musculoskeletal complications.

Keywords

shoulder pain

upper limb amputation

prosthetic devices

veterans

contralateral shoulder pain

body-powered prostheses

externally powered prostheses

health-related quality of life

QuickDASH scores

musculoskeletal complications